Getting Ahead

Migraine is not a new or a rare disease: references to migrainelike conditions can be found as far back as Ancient Egypt, and it has been recognised by the WHO as one of the top 10 causes of years lost to disability worldwide (1-2). Despite this, migraine patients in need of a preventive option are likely to be prescribed a medication that has been developed for another condition such as epilepsy or depression, rather than something that was designed with migraine in mind. However, there is hope that this will soon change.

Pathophysiology of Migraine

The understanding of the pathophysiology of migraine has advanced hugely over the past two decades. While in the past theories of migraine focused on the vascular system, research has moved away from this towards a neuronal theory of migraine (3). However, the role of blood vessels and vasodilation is still not entirely understood.

Migraine is a complex neurological disease of the central nervous system (CNS), with several structures and brain areas implicated in its genesis. A key focus area has been the trigeminovascular system. This has connections with other key brain areas with axons reaching as far as the meninges. Activation of this system is thought to be a crucial step in a chain of events leading to migraine pain.

Professor Dr Uwe Reuter is a neurologist and partner in the headache programme at Charité Universitätsmedizin, Berlin. After finishing his residency training in Berlin, he went to Harvard Medical School for a post-doctorate fellowship as a scholar for three years. During his time in Boston, Uwe focused on basic research in primary headaches and migraine aura and published several peer-reviewed publications in high impact journals. Ever since, he has had a strong interest in basic and clinical headache research. Uwe is a member of several national and international headache organisations and currently serves as board member of the European Headache Federation.

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